Provider Demographics
NPI:1053629261
Name:MARTINEZ CHIROPRACTIC, INC.
Entity Type:Organization
Organization Name:MARTINEZ CHIROPRACTIC, INC.
Other - Org Name:CATALINA NATURAL HEALTH CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:LOUIS
Authorized Official - Last Name:MARTINEZ
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:310-510-0024
Mailing Address - Street 1:PO BOX 1931
Mailing Address - Street 2:
Mailing Address - City:AVALON
Mailing Address - State:CA
Mailing Address - Zip Code:90704-1931
Mailing Address - Country:US
Mailing Address - Phone:310-510-0024
Mailing Address - Fax:310-510-9566
Practice Address - Street 1:126 SUMNER AVE.
Practice Address - Street 2:SECOND FLOOR
Practice Address - City:AVALON
Practice Address - State:CA
Practice Address - Zip Code:90704-1931
Practice Address - Country:US
Practice Address - Phone:310-510-0024
Practice Address - Fax:310-510-9566
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-22
Last Update Date:2010-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC23905111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAU68290Medicare UPIN